TODD MICHAEL MINER MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****92

License Status

NOT RENEWED

Business

First Name

TODD

Middle

MICHAEL

Last Name

MINER

Suffix

Business Name

TODD MICHAEL MINER MD

Original Issue Date

06/17/1999

Effective Date

06/17/1999

Expiration Date

07/31/2002

City

WINFIELD

State

Zip

60190

County

DUPAGE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/09/2006